Surgical device

ABSTRACT

A surgical device for joining broken bone segments includes a rail member configurated to abut against one segment of the bone and has an aperture therein. A holder member has an aperture therein and is configurated to slide along the rail member and has a longitudinal slot through which fixing screws can pass and engage with the rail member for fixing the members against relative movement with respect to one another. An elongated connecting means passes through the apertures of the rail member and of the holder member. Each of the apertures define a pivot point in which the elongated member is pivotally mounted and forms an angle with the bone which is a function of the relative positions of the two members. One end of the elongated member is anchored to the holder member and another end is fixed to another segment of the bone, the elongated member being arranged to pull the last-mentioned segment towards said holder member while abutting against said rail member.

ilnited Mates Patent [19] Fischer Jan. 1,1974

[ SURGICAL DEVICE [76] Inventor: Artur Fischer, Altheimer Strasse 219,Tumlingen, Germany [22] Filed: Aug. 16, 1972 [21] Appl. No.: 281,057

[30] Foreign Application Priority Data Aug. 17, 1971 Germany 2141111[52] US. Cl. 128/92 BB [51] Int. Cl. A6 5/04 [58] Field of Search 128/92BB, 92 B, 128/92 BA, 92 BC, 92 R, 92 C, 92 CA, 92 D [56] ReferencesCited UNITED STATES PATENTS 3,530,854 9/1970 Kearney 123/92 R 2,699,7741/1955 Livingston 128/92 BB 2,381,050 8/1945 Hardinge 128/92 BB3,678,925 7/1972 Fischer et a1. 128/92 BB FORElGN PATENTS ORAPPLICATIONS 918,531 8/1954 Germany 128/92 BB 373.516 l/l964 Switzerland128/92 BB Primary Examiner-Richard A. Gaudet Assistant ExaminerJ. YaskoAttorney-Michael S. Striker [57] ABSTRACT A surgical device for joiningbroken bone segments includes a rail member configurated to abut againstone segment of the bone and has an aperture therein. A holder member hasan aperture therein and is configurated to slide along the rail memberand has a longitudinal slot through which fixing screws can pass andengage with the rail member for fixingthe members against relativemovement with respect to one another. An elongated connecting meanspasses through the apertures of the rail member and of the holdermember. Each of the apertures define a pivot point in which theelongated member is pivotally mounted and forms an angle with the bonewhich is a function of the relative positions of the two members. Oneend of the elongated member is anchored to the holder member and anotherend is fixed to another segment of the bone, the elongated member beingarranged to pull the last-mentioned segment towards said holder memberwhile abutting against said rail member.

9 Claims, 2 Drawing Figures SURGICAL DEVICE BACKGROUND OF THE INVENTIONThe present invention concerns a surgical device, particularly forjoininga broken bone, and more especially for joining a bone broken inthe region of the neck of the femur head.

In multiple bone fractures, in which in particular the neck of the femurhead and the femur are affected, it is necessary for rapid healing ofthe fracture that the bone fragments be drawn together and held in thisposition. In the case of the femur, this is effected by means of a railfastened to the bone fragments by screws. Since during the applicationof the rail no forces come into action which may cause gaps between thebone fragments at the line of fracture, this rail ensures rapid healingand support of the broken bone.

In order to obtain also in the case of a fracture of the neck of thefemur head a rapid formation of callus, at the surface or line of thefracture, the fragments must be in contact at the surface of fracture.This can be achieved only by driving into the bone a connection elementwhich can subsequently be anchored in the rear bone fragment. The bonefragments can then be drawn together by means of a capping sleeve thatcan be screwed onto a part of the connection element which is allowed toprotrude from the bone. In the case of simple fractures of the neck ofthe femur head, in which the connection element could be driven in atthe specific angle between the neck of the femur head and the femur,this kind of connection has proved very suitable.

Depending upon the course of the fracture, however, the connectionelement must in many cases be driven into the neck of the femur head a adifferent angle. The angular range between the femur and the connectionelement to be driven into the neck of the femur head, which can beconsidered for this purpose varies approximately from l to 140". Inthese cases, there is no contact face available for engagement by thecapping sleeve, it being understood that such contact face should extendperpendicular to the longitudinal axis of the connection element andshould support the capping sleeve during the drawing-together of thebone fragments. The joining of the bone fragments thus becomes verydifficult, or even impossible. Moreover, it is necessary in multiplefractures, due to the high loads on the femur, to provide a rigidconnection between the rail fastened to the femur and the connectionelement secured in the neck of the femur head.

A rail is known, one end of which has the shape of a circular are. Thisrail is fixed to the femur in the manner described above. The arc,forming one piece with the rail, contains a longitudinal groove, inwhich a nail that is to be driven into the neck of the femur head can bemoved. Depending upon the position of the nail along the arc, a specificangle of the nail in relation to the femur is obtained. The nail isfixed in this position by a support plate which may be placed onto thatend of the nail which protrudes from the bone, and which serves as backsupport for the rail which is to be fastened to the nail by a screw. Therail is then immovably clamped between the support plate and the head ofthe screw.

The known rail cannot, however, be used in association with a connectionelement of the type described above, since a support plate cannot befixed to the end Moreover, the support plate required by the knowndevice, which, due to its large surface, cannot penetrate into the boneand therefore lies upon the bone, prevents a contact between the railand the femur. Only the rear part of the known rail, and the supportplate are in contact with the bone when the known device has been fixed.The femur thus lacks lateral support, which is required to preventdisplacement of the bone fragments at the line of fracture in the femur.

SUMMARY OF THE INVENTION It is a general object of the invention toovercome the disadvantages of the prior art.

More particularly, it is an object of the invention to provide animproved surgical device which avoids such disadvantages.

Another object is to provide such an improved device which makes itpossible to obtain a rigid connection between the fragments of the femurwhich are held together by a rail constituting a part of the device.

According to the invention this is achieved by providing the rail withan aperture which serves at the same time as seat and as pivot point forthe connection element, the connection element being pivotable aboutthis pivot point by means of a holder which can be moved along the railand fixed at the rail and which also contains an aperture for taking upthe connection element.

After the connection element has been inserted and anchored at an angleto the femur which depends on the position and the course of thefracture line, as a rule at between and M0", the rail and the holder,which can be moved along the rail and fixed at the rail, are togetherpushed over the protruding end of the connection element. The cappingsleeve required for joining the bone fragments is then pushed throughthe apertures in the holder and in the rail and is screwed onto theprotruding end of the connection element. Only now is the rail screwedto the femur with the aid of fixing screws. By moving the holder alongthe rail, the already anchored fixing element is clamped by means of thecorrespondingly matched apertures in the holder and in the rail, andfixed in this position by tightening the holder to the rail. Thefragments of the neck of the femur head are now drawn together by meansof the capping sleeve. The head of the capping sleeve is supportedeither by a washer or directly by the correspondingly shaped holder.

The connection element may be any expansion belt which permits anchoringby means of expansion (i.e. spreading apart), and which utilizes acapping sleeve or nut by means of which the bone fragments can be drawntogether.

The pivoting range of l2 0 to made possible by this solution suffices innearly all cases for driving in the connection element according to thecourse of the fracture and for producing a rigid connection with therail,

and at the same time providing contact between the rail and the femur.This rigid connection between the connection element and the rail whichis fixed to the femur, provides the condition for rapid healing and forthe possibility of immediately subjecting the femur to a load.

The lateral support by the rail, which is in contact with the femur overits entire length, prevents a displacement of the bone fragments at thepositions of fracture and thus a wrong growing-together of the femur.

Compared to the prior art, the construction according to the inventionhas the further advantage that when a load is applied to the femur, theclamping effect obtained in the connection between the connectionelement and the rail, is reinforced.

According to a further concept of the invention, the aperture in therail and in the holder may be widened from the contact side with thebone in accordance with the pivoting angle of the connection element.This construction makes it possible to select narrower drill holetolerances for the seating of the connection element in the rail and inthe holder. The widening is, however, required only in the longitudinaldirection of the drill hole, so that proper lateral support for theconnection element remains assured.

According to a further advantageous concept of the invention, that partof the holder which contains the aperture for taking up the connectionelement, may be bent in such a way that it is positioned approximatelyperpendicular to the longitudinal axis of the connection element. Thisproduces a rectangular contact face for the head of the capping sleeveto be screwed onto the connection element, which contact face couldotherwise be obtained only by means of a bearing plate. Also, the holdermay be attached to the rail by means of one or several fixing screws,which are guided in a longitudinal aperture extending parallel to itslateral edge. In this construction, the holder can be moved along therail and fixed to the rail in a most simple manner for the purpose ofpivoting and clamping the connection element; to avoid subsequentpainful pressure spots, the screw heads may be recessed in thelongitudinal aperture of the holder.

According to a last development of the invention, suitable means, inparticular screws, may be arranged at the holder, for clamping theconnection element which has been taken up in the aperture of theholder. This construction prevents the accidental loosening of thecapping sleeve which is necessary for the drawingtogether andholding-together .of the bone fragments.

The novel features which are considered as characteristic for theinvention are set forth in particular in the appended claims. Theinvention itself, however, both as to its construction and its method ofoperation, together with additional objects and advantages thereof, willbe best understood from the following description of specificembodiments when read in connection with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWING:

FIG. 1 is a partial sectional view of a device according to theinvention; and

FIG. 2 shows the construction of the aperture in the rail serving fortaking up the connection element.

DESCRIPTION OF THE PREFERRED EMBODIMENTS:

The device according to the invention comprises a connection element 2in form of an expansion anchor, which may be anchored in the neck of thefemur head 1, a rail 5 which is fastened to the femur 3 by means offixing screws 4, and a holder 6 which can be moved along the rail andfixed at the rail. The connection element 2 has a capping sleeve 7 ornut which may be screwed onto that end of the connection element 2 thatprotrudes from the bone, a head 8 of which capping sleeve is supportedby a bent section 9 of the holder 6 when the bone fragments are drawntogether. Although several fracture lines have been indicated it shouldbe understood that the device could be used with a nonfractured bone, aswill be explained more fully at a subsequent point.

The rail 5 is provided with an aperture 10 for taking up the connectionelement 2. The aperture is widened (i.e., diverges) in the longitudinaldirection of the rail 5 from the contact side with the bone, accordingto the pivoting range of the connection element 2 (see also FIG. 2).

The rail 5 further contains apertures 11 for taking up the fixing screws4, by means of which the rail 5 is fastened to the femur 3. An uppersection 12 of the rail 5 is contoured to conform to a high degree of theouter surface of the femur 3, so that the contact face for the lateralsupport of the femur 3 is as large as possible.

To use the novel device, a nail (not shown) is first driven into thefemur 3 for forming a hole therein. As this is done, the bone isobserved on the screen of an X-ray machine to assure that the desiredangle 16 be tween the passage formed by the nail and the rail 15, isobtained. Now, the sleeve of element 2 is placed over the protrudingrear end of the nail and driven into the bone, so as to slide over andalong the nail. When this is completed, the nail has no further purposeand is withdrawn. The screw which effects expansion of the sleeve is nowthreaded into the expansion body of the element 2 and turned as requiredto expand the sleeve of element 2, thereby anchoring the latter in thefemur 3. Now, the rail 5 is placed over the end portion of element 2which protrudes outwardly of the bone, and is screwed to the latter bythe screws 4. Capping sleeve 7 and holder 6 are then pushed onto theprojecting portion of element 2 and threaded onto the same until sleeve7 enters aperture 10. The holder 6 is then secured to rail 5 untilscrews 15 and its bent section 9 then acts as an abutment for the head 8of sleeve 7, permitting the drawing-together of the bone fragments orsections in response to requisite turning of sleeve 7.

In order to pivot the connection element 2 in the aperture 1.0 of therail 5, serving as pivot point, the holder 6 is moved upwards ordownwards. In the holder 6 too, the aperture 13, provided for taking upthe connection element 2, is widened (i.e., diverged) in accordance withthe pivoting range. The movement of the holder 6 is made possible by theposition of the longitudinal aperture 14. The holder 6 is fixed to therail 5 by means of fixing screws 15 which are guided in the longitudinalaperture 14. The angle 16 between the connection element 2 and the rail5 varies in dependence on the displacement of the two apertures 10, 13in the rail 5 and in the holder 6. The angle 16 is selected as requiredby shifting of the holder 6 relative to rail 5, whereupon the selectedangle is then set by fixing the holder 6 on the rail 5 with the aid ofthe screws 15.

After drawing together the bone fragments, the capping sleeve 7 isclamped by means of the fixing screws 17 at the bent section 9 0f theholder 6, and thus secured against accidental loosening.

l wish it to be expressly understood that the usefulness of my device isnot limited to cases where a bone fracture has actually occurred. Thereare instances where my device can be employed to advantage even if nofracture exists. For instance, it is well known that the bones of olderpersons are much more susceptible to fracturing than those of youngerpersons. In such circumstances my device could be used as a preventive,i.e., it could be installed on an unfractured bone to give the samesupport and forstall the occurrence of a fracture. This use is intendedto be encompassed in the pro tection of the appended claims.

It will be understood that each of the elements described above, or twoor more together, may also find a useful application in other types ofapplications differing from the types described above.

While the invention has been illustrated and described an embodied in asurgical device, it is not intended to be limited to the details shown,since various modifications and structural changes may be made withoutdeparting in any way from the spirit of the present invention.

Without further analysis, the foregoing will so fully reveal the gist ofthe present invention that others can by applying current knowledgereadily adapt it for various applications without omitting featuresthat, from the standpoint of priorart fairly constitute essentialcharacteristics of the generic or specific aspects of this inventionand, therefore,such adaptations should and are intended to becomprehended within the meaning and range of equivalence of thefollowing claims.

What is claimed as new and desired to be protected by Letters Patent isset forth in the appended l. A surgical device, particularly for joiningsegments of an elongated broken bone such as a femur bone, comprising afirst member connectable to at least one segment of the bone so as toextend longitudinally of the latter, said first member having a firstaperture; an adjustable second member slidably mounted on said firstmember and having a second aperture, each of said apertures beingtapered and defining on each of said members a pivot point; fixing meansfor fixing said first and second members in one of a plurality ofrelative positions; and elongated means arranged to pass through andpivot about the pivot points of each of the respective apertures and besecurely fixed at one end portion to at least another of the bonesegments while having another end portion arranged to abut against saidsecond member for holding said other bone segment to said second member,said elongated member forming an angle with the elongation of said firstmember, and thereby of the bone which is a function of the relativeposition between said first and second members.

2. A surgical device as defined in claim 1, wherein said first membercomprises a rigid rail configurated to extend along and abut against atleast a part of the bone.

3. A surgical device as defined in claim 1, wherein said first member isconnected to a segment of the bone by means of screws.

4. A surgical device as defined in claim 1, wherein each of saidapertures taper in diameter in a direction away from the bone.

5. A surgical device as defined in claim 1, wherein said firstand secondmembers each have substantially straight portions arranged for slidingmovement relative to one another, and wherein said second member has afurther portion including an angle with the straight portion of saidsecond member such that said further portion is substantially normal tosaid elongated member.

6. A surgical device as defined in claim 1, wherein said first andsecond members each have substantially straight portions arranged forslding movement relative to one another, and wherein said portion ofsaid second member is provided with a longitudinal slot, said fixingmeans passing through said slot and engaging said portions of said firstand second members.

7. A surgical device as defined in claim 6, wherein said fixing meanscomprises screws.

8. A surgical device as defined in claim 1, wherein said elongated meanshas portion positioned in said second aperture; and further comprisinglocking means on said second member in the region of said secondaperture for engaging said portion and preventing movements of saidelongated member relative to said second member.

9. A surgical device as defined in claim 1, wherein said locking meanscomprises a fixing screw.

1. A surgical device, particularly for joining segments of an elongatedbroken bone such as a femur bone, comprising a first member connectableto at least one segment of the bone so as to extend longitudinally ofthe latter, said first member having a first aperture; an adjustablesecond member slidably mounted on said first member and having a secondaperture, each of said apertures being tapered and defining on each ofsaid members a pivot point; fixing means for fixing said first andsecond members in one of a plurality of relative positions; andelongated means arranged to pass through and pivot about the pivotpoints of each of the respective apertures and be securely fixed at oneend portion to at least another of the bone segments while havinganother end portion arranged to abut against said second member forholding said other bone segment to said second member, said elongatedmember forming an angle with the elongation of said first member, andthereby of the bone which is a function of the relative position betweensaid first and second members.
 2. A surgical device as defined in claim1, wherein said first member comprises a rigid rail configurated toextend along and abut against at least a part of the bone.
 3. A surgicaldevice as defined in claim 1, wherein said first member is connected toa segment of the bone by means of screws.
 4. A surgical device asdefined in claim 1, wherein each of said apertures taper in diameter ina direction away from the bone.
 5. A surgical device as defined in claim1, wherein said first and second members each have substantiallystraight portions arranged for sliding movement relative to one another,and wherein said second member has a further portion including an anglewith the straight portion of said second member such that said furtherportion is substantially normal to said elongated member.
 6. A surgicaldevice as defined in claim 1, wherein said first and second members eachhave substantially straight portions arranged for slding movementrelative to one another, and wherein said portion of said second memberis provided with a longitudinal slot, said fixing means passing throughsaid slot and engaging said portions of said first and second members.7. A surgical device as defined in claim 6, wherein said fixing meanscomprises screws.
 8. A surgical device as defined in claim 1, whereinsaid elongated means has portion positioned in said second aperture; andfurther comprising locking means on said second member in the region ofsaid second aperture for engaging said portion and preventing movementsof said elongated member relative to said second member.
 9. A surgicaldevice as defined in claim 1, wherein said locking means comprises afixing screw.